LASIK Surgery Not For Everyone

LASIK Surgery: Not for Everyone

I guess you're all familiar with refractive surgery - surgery that corrects visual acuity with the purpose of reducing or eliminating the need for contacts and glasses. Well, in today's fast-paced technological world, one of the most commonly performed refractive surgery is what the experts call as "LASIK". You may hear people calling it "LASIX", but the name actually stands for "Laser- Assisted-In-Situ-Keratomileusis".

Now, what basically is LASIK?

It is given that LASIK is a surgical procedure intended to reduce or eliminate the person's dependency on glasses or contact lenses. This procedure is actually "outpatient", thus you have the chance to go home after the operation. It is performed by a refractive surgeon in order to correct any refractive problems like myopia, hyperopia and astigmatism.

Basically, the LASIK surgery permanently changes the shape of the cornea, the clear covering of the front of the eye, with the use of excimer laser. Also, a knife, medically known as microkeratome, is used to cut a flap in the cornea. Then, a hinge is left at one end of this flap. The flap is folded back revealing the stroma, which is the middle section of the cornea. The procedure further involves vaporization of a portion of the stroma, and that what allows you to smell somewhat like a burning hair during the procedure. After which, the flap is re- placed on its original position.

Is LASIK For You?

One particular truth when it comes to LASIK surgery is that, it is not for everyone. There are a number of medical conditions that some people have that make them poor candidates for this refractive procedure. Well, these conditions are in the first place rare and can only be determined or detected during your pre-procedure examination with what is called a Corneal Topographical Map.

Preoperative Tests

I have here below some of the preoperative tests that you will need to undergo prior to initiating the LASIK procedure for myopia, hyperopia, or astigmatism. These tests are highly required in order to make certain that you obtain the most accurate and proper correction as well as follow up possible. These tests include, but are not limited to:

Complete Eye Examination

A complete eye examination, including pupil dilation, is necessary to determine the refractive power and health of your eye. It is particularly used to determine the refractive error, which is verified with a cycloplegic or dilated technique. Along with this, several tests are made available to determine if you predisposed to Dry Eye Syndrome and related symptoms.

Usually, in this evaluation exam, you will be evaluated for your expectations of what refractive surgery will do for you. It is commonly suggested that if you wear contact lenses, you must stop wearing the lenses for a few weeks prior to the examination. The usual period range from:

? Three weeks for soft daily wear lenses ? Six weeks for gas permeable and extended wear soft contact lenses ? Eight weeks for hard plastic lenses on at least one eye and wear glasses or one contact lens during this period of time.

It is worth noting that the actual time needed for the removal of contact lenses may vary depending upon the recommendation of the doctor for your particular case. Also, the main purpose for the removal of the contact lenses during such period is to attain the most accurate measurements of your natural corneal curvature. To further know this, you may be required to undergo some measurements which are taken every week for a number of weeks prior to the LASIK surgery. This is to make sure that your cornea is stable. Experts say that if your cornea stabilizes sooner than expected after the removal of the contact lens, your LASIK surgery may be done sooner.

Computerized Topographical Analysis

This preoperative test is also known as Computerized Video Keratography and is a mapping of the surface of the eye by height as well as refractive power. In this kind of procedure, the more sophisticated machine is used to measure the thickness of the cornea, as well as the elevation of the front and back surfaces of the cornea. This is usually performed to detect evidences of corneal thinning that are hidden, which might occur in the hidden form of kerataconus.

Tonometry

Before the refractive LASIK surgery, tonometry is taken for a certain purpose - to determine the intraocular pressure. Basically, this measurement is just a normal part of a complete eye examination.

Contrast Sensitivity Analysis

The contract sensitivity analysis may also be done prior to the surgery. This basically measures the ability of your eye to distinguish images under varying degrees of lighting. It was found out that in some people, laser refractive surgery may cause a decrease in the ability to see at low light levels.

Pachymetry

There is only particular purpose for the consideration of this test - to determine the thickness of the cornea. According to some resources, the thickness of your cornea must be measured in order for the surgeon to identify your suitability for the LASIK procedure. As noted, the absolute minimum of residual thickness is 250 microns. So, if the depth of the ablation or the optical zone leaves less than 250 microns of residual corneal tissue, the danger of the cornea shape changing, or blowing out is greatly elevated. Some of the refractive surgeons like to leave 270 to 275 microns of residual cornea in order to give a safety margin to allow for improvement.

If all these preoperative tests are taken, your surgeon and staff will proceed to analyzing the results to determine your chances of success with the LASIK procedure.

Conditions Which May Preclude Your Eligibility for LASIK

As mentioned earlier, the LASIK procedure is not for everyone. If you have any of the conditions below, you are probably not a good candidate for refractive surgery.

Cost is an Issue

Are you one of those who often worry of the cost of LASIK? You should understand in the first place that most medical insurance will not pay for refractive surgery. And, although the cost is coming down, it is still one of the most important factors to consider.

Not a Risk Taker

When it comes to LASIK and other refractive surgeries, certain complications are unavoidable, and this happened in a percentage of patients. Aside from that, there are no long-term data available for current procedure. So, if you are not a risk taker, then LASIK is probably not for you.

It Will Jeopardize Your Career

As you may know, some jobs these days prohibit certain refractive procedures. Therefore, it is important, if you are working, to be sure to check with your employer service before undergoing any LASIK procedure.

Refractive Instability

Refractive instability is a condition in which you required a change in your contact lens or glasses prescription in the past year. The patients who are more likely to have refractive instability are those who are:

? In their early 20s or younger ? Pregnant or breastfeeding ? Taking medications that may cause fluctuations in vision ? Whose hormones are fluctuating due to disease like diabetes Experts suggest that those people should discuss the possible additional risks wit their surgeon or doctor.

With a Disease or On Medications that Prevent Healing

You are not qualified to take a LASIK procedure if you are suffering from certain conditions that may affect wound healing. Included in the list are those autoimmune diseases like lupus and rheumatoid arthritis, as well as immunodeficiency states like HIV and diabetes. You are not also qualified for the LASIK if you are taking medications like retinoic acid and steroids as they may prevent healing after a refractive procedure.

Contact Sports Participant

If you are actively participating in some contact sports like boxing, wrestling, martial arts or other activities in which blows to the face and eyes, then you are not a candidate for LASIK eye surgery.

Not an Adult

Are you still below 18 years old? If so, then you must know that currently, no lasers are approved by the FDA and other organizations for LASIK on persons under the age of 18.

Aside from those above mentioned conditions, there are also some precautions that you must take note before considering a LASIK procedure. Note that the safety as well as effectiveness of refractive procedures like LASIK has not been identified in patients with some diseases. If you have a history of any of the following, don't forget to discuss with your doctor or surgeon:

? Glaucoma, glaucoma suspect, or ocular hypertension ? Herpes simplex or herpes zoster or shingles involving the eye area ? Eye diseases such as uveitis/iritis, commonly known as inflammation of the eye ? Keratoconus ? Eye injuries or previous eye surgeries

Other Factors

Before jumping headfirst to a LASIK procedure, your doctor should examine you for the following conditions. Note that these are indicators of risk:

? Thin Corneas - Probably you all know that the cornea is the thin clear covering of the eye that is over the iris, which is the colored part of the eye. Well, most of the refractive surgeries change the focusing power of the eyes by way of reshaping the cornea. An example of this could be the removal of tissue. So, performing a LASIK procedure, which is refractive, on a cornea that is too thin may result blinding complications. If you have thin corneas, then LASIK is not for you.

? Dry Eyes - The Dry Eye Syndrome is actually one of the most common complications after LASIK. Well, it is not exclusive to people who have had refractive surgery, but it has developed into the most common complication after laser vision correction.

? Large Pupils - When taking an eye examination, be sure that the evaluation is done in a dark room. A reason for this could be the fact that younger patients, as well as those who are on certain medications may be prone to having large pupils under dim lighting conditions. According to some experts, this can trigger symptoms like halos, glare, ghost images (double vision), and starbursts to occur after surgery. Most patients consider these symptoms debilitating. Perhaps one particular example of this is a patient who cannot take anymore to drive a car at night or in certain weather conditions, like fog.

? Previous Refractive Surgery - Most surgeons do not recommend additional refractive surgery once you have undergone a particular procedure. Accordingly, the decision to have additional refractive procedure must be made in consultation with your doctor after careful consideration of your situation.

? Blepharitis - One of the factors that trigger to increase inflammation or infection of the cornea after the LASIK is blepharitis, which is an inflammation of the eyelids with crusting of eyelashes. So, if you have this condition, better not consider refractive surgery.

Risks Involved With LASIK Eye Surgery

Probably you know that some patients are very pleased with the outcomes of their LASIK surgery. However, like any other medical procedure, there are some dangers involved. Given this fact, it is then very important for you to understand the limitations as well as some possible complications of refractive surgery like LASIK.

So before you consider a LASIK procedure, you should carefully weigh the risks and some benefits of LASIK based on your own personal value system. And, if you have friends who have had the procedure and encouraging you to do so, simply try to avoid being influenced by them.

Here are a few of the common risks involved with LASIK:

? Loss of Vision - Most patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses, or surgery as a result of treatment.

? May be Under Treated or Over Treated - It has been reported that only a certain percent of patients achieve 20/20 vision without glasses or contacts, after the surgery. Well, in this case, you may need additional treatment, however additional treatment may not be possible. So, you have no choice but to have your glasses or contact lenses even after the procedure. This in fact may be true even if you only needed a very weak prescription prior to the surgery. As often said, if you use reading glasses before surgery, you may still need reading glasses after the procedure.

? Development of Debilitating Visual Symptoms - Most of the LASIK patients develop halos, double vision, and glare that can seriously affect the nighttime vision. Although patients have a good vision on a vision chart, many of them see as well in situations of low contrast, like at night or in fog.

? Severe Dry Eye Syndrome - As mentioned earlier a dry eye syndrome is one of the most common complications after LASIK. With this condition, you may not be able to produce enough tears to keep your eye moist and comfortable. Note that it does not only cause discomfort, but it can lessen the quality of vision perhaps due to intermittent blurring and some other symptoms. And, perhaps one big risk of this condition is that it may be permanent. In this case, you may need intensive drop therapy as well as use of plugs or other procedures.

? Long Term Data is Not Available - As you all know, LASIK is a new technology. The first well-known laser was approved for LASIK eye surgery just in 1998. Thus, the long term safety as well as the efficiency of LASIK is not yet known.

? Results May Diminish With Age - This is common among farsighted patients. It is noted that if you are farsighted, the level of improved vision you experience after surgery may decrease with age. The probable cause of its occurrence is the difference of your manifest refraction from your cycloplegic refraction. Your manifest refraction is actually a vision examination with lenses before dilating drops, while your cycloplegic refraction is a vision exam with lenses after dilating drops.

I think enough is said about LASIK eye surgery. The most important thing to note here is that LASIK is a procedure not intended for everyone. As presented, there are certain conditions under which LASIK eye surgery is not recommended. And, these conditions can be detected when you have your preoperative tests such as those mentioned above. Note also that there are rare individuals who have some eye disease or other condition which could worsen with LASIK. So, it is very necessary for you to be aware of its possible risks, complications, or contraindications before considering one. Simply know what the procedure can and cannot do for you.